Republic of the Philippines

Department of Finance
Bureau of Intenatl Revenue
BIR Form No.
Certificate of Compensation
2316
January 2018 (ENCS)
Payment/Tax Withheld
For Compensation Payment With or Without Tax Withheld 2316 01/18ENCS
Fill in all applicable spaces. Mark all appropriate boxes with an "X"
1 For the Year 2 For the Period
( YYYY )
2023 From (MM/DD)
09 01 To (MM/DD)
12 31
Part I - Employee Information Part IV-B Details of Compensation Income and Tax Withheld from Present Employer
3 TIN
628 143 324 0000 A. NON-TAXABLE/EXEMPT COMPENSATION INCOME
4 Employee's Name (Last Name, First Name, Middle Name) 5 RDO Code Amount
27 Basic Salary(including the exempt P250,000 & below)
PALLAYA, KATE NICOLINE AMBATALI 014 of the Statutory Minimum Wage of the MWE
34,000.00
6 Registered Address 6A Zip Code 28 Holiday Pay (MWE)
0.00
29 Overtime Pay (MWE)
6B Local Home Address 6C Zip Code 0.00
30 Night Shift Differential (MWE)
0.00
6D Foreign Address 6E Zip Code 31 Hazard Pay (MWE)
0.00
32 13th Month Pay and Other Benefits
7 Date of Birth (MM/DD/YYYY) 8 Telephone Number (maximum of P90,000)
2,730.00
33 De Minimis Benefits
0.00
9 Statutory Minimum Wage rate per day 34 SSS, GSIS, PHIC & Pag-ibig Contributions
0.00 and Union Dues (Employee share only) 2,730.00
10 Statutory Minimum Wage rate per month 35 Salaries & Other Forms of Compensation
0.00 0.00
11 X Minimum Wage Earner whose compensation is exempt from 36 Total Non-Taxable/Exempt Compensation
39,460.00
withholding tax and not subject to income tax Income (Sum of Items 27 to 35)
Part II - Employer Information (Present)
12 Taxpayer B. TAXABLE COMPENSATION INCOME REGULAR
008 381 324 0000
13 Employer's Name 37 Basic Salary
UNITED METHODIST CHRISTIAN SCHOOL OF 0.00
BAYOMBONG, IN 38 Representation
14 Registered Address 14A Zip Code
LB PEREZ DON DOMINGO MADDELA 39 Transportation
3700
BAYOMBONG NUEVA VIZCAYA
15 Type of Employer Main Employer Secondary Employer 40 Cost of Living Allowance (COLA)

Part III - Employer Information (Previous) 41 Fixed Housing Allowance

16 TIN
42 Others (Specify)
17 Employer's Name 42A
0.00
42B
18 Registered Address 18A Zip Code

SUPPLEMENTARY
Part IVA - Summary
19 Gross Compensation Income from Present 43 Commission
Employer (Sum of Items 36 and 50) 0.00
20 Less: Total Non-Taxable/Exempt Compensation 44 Profit Sharing
Income from Present Employer (From Item 36) 39,460.00
21 Taxable Compensation Income from Present 45 Fees Including Director's Fees
Employer (Item 19 Less Item 20) (From Item 50) 0.00
22 Add: Taxable Compensation Income from 46 Taxable 13th Month Pay Benefits
Previous Employer, if applicable 0.00 0.00
23 Gross Taxable Compensation Income 47 Hazard Pay
(Sum of Items 21 and 22) 0.00
24 Tax Due 48 Overtime Pay
0.00
25 Amount of Taxes Withheld 49 Others (Specify)
25A Present Employer 49A
0.00
25B Previous Employer 49B
0.00
26 Total Amount of Taxes Withheld as adjusted 50 Total Taxable Compensation Income
(Sum of Items 25A and 25B) 0.00 (Sum of Items 37 and 49B) 0.00
I/We declare, under the penalties of perjury, that this certificate has been made in good faith, verified by us, and to the best of my/our knowledge and belief, is true and correct pursuant to
the provisions of the National Internal Revenue Code, as amended, and the regulations issued under authority thereof. Further, I/we give my/our consent to the processing of my/our information
as contemplated under the *Data Privacy Act of 2012 (R.A. No. 10173) for legitimate and lawful purposes.

51 LORMA J. BASILIO
Present Employer/ Authorized Agent Signature Over Printed Name Date Signed

CONFORME:
KATE NICOLINE AMBATALI
52 PALLAYA Date Signed
Employee Signature Over Printed Name Amount Paid, if CTC
CTC/Valid ID No. Place of Date of Issue
of Employee Issue
To be accomplished under substituted filing
I declare, under the penalties of perjury, that the information herein stated are reported I declare,under the penalties of perjury that I am qualified under substituted filing of
under BIR Form No. 1604C which has been filed with the Bureau of Internal Revenue. Income Tax Returns(BIR Form No. 1700), since I received purely compensation income
from only one employer in the Philippines for the calendar year; that taxes have been
correctly withheld by my employer (tax due equals tax withheld); that the BIR Form
53 LORMA J. BASILIO No. 1604-C filed by my employer to the BIR shall constitute as my income tax return;
Present Employer/ Authorized Agent Signature Over Printed Name and that BIR Form No. 2316 shall serve the same purpose as if BIR Form No. 1700
(Head of Accounting/ Human Resource or Authorized Representative) has been filed pursuant to the provisions of Revenue Regulations (RR) No. 3-2002, as amended.

54
KATE NICOLINE AMBATALI PALLAYA
Employee Signature Over Printed Name
*NOTE: The BIR Data Privacy is in the BIR website (www.bir.gov.ph)